Top of the pageDecision Point

You may want to have a say in this decision, or you may simply want to follow your doctor’s recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Irritable Bowel Syndrome: Should I Have Tests for IBS Symptoms?

Get the facts

Your options

  • Accept your doctor’s diagnosis of irritable bowel syndrome. Try
    home treatment. If it helps your symptoms, you may feel reassured that you
    have IBS rather than another problem.
  • Have tests to make sure that you don’t have a more serious
    problem.

Key points to remember

  • There are no tests that can diagnose
    irritable bowel syndrome (IBS). Instead, experts use a
    set of
    criteria that help your doctor decide whether you have
    IBS. Your doctor probably will ask you a lot of questions about your symptoms
    to see how well your symptoms match these criteria.
  • If your symptoms get better with home care and changes to your
    diet, you likely have IBS and don’t need tests for other digestive problems. If
    your symptoms don’t get better, your doctor probably will want you to have some
    tests.
  • If you have IBS, your test results for other digestive problems
    will be normal. An abnormal test result may mean that you have a problem other
    than IBS.
  • If your tests are all normal and your symptoms match the
    symptoms common in people with IBS, you probably don’t have a serious problem.
    You and your doctor can then focus on relieving your symptoms so that they
    don’t interfere with your life.
  • When deciding whether to have tests, weigh the chance that you
    may have a more serious problem against the risks, discomfort, and costs of
    tests.
  • If any of the following apply to you, your doctor probably
    will want to do tests to make sure that you don’t have a more serious problem:

    • You are older than 50.
    • You have blood or pus in your stool.
    • Your symptoms have come on quickly over the past few weeks
      to months.
    • You have had unexplained weight loss, fever, or diarrhea at
      night.
    • Your pain wakes you up at night.
FAQs

What is irritable bowel syndrome (IBS)?

Irritable bowel syndrome (IBS) is a common digestive
problem. Many people have symptoms of IBS (such as diarrhea, constipation,
bloating, and belly pain) and never see a doctor about them. Other people may
choose to see a doctor because they are concerned about their symptoms or
because the symptoms are affecting their life.

It is not clear what causes irritable bowel syndrome, and the cause may be different for different people. Some ideas about what causes IBS include problems with the way signals are sent between the brain and the digestive tract, problems digesting certain foods, and stress or anxiety. People with IBS may have unusually sensitive intestines or problems with the way the muscles of the intestines move.

There are no tests that can diagnose IBS. Instead,
experts use a set of
criteria that help your doctor decide whether you may
have IBS. Your doctor will likely ask you a lot of questions about your
symptoms to see how well your symptoms match these criteria.

Treating the symptoms of IBS can improve your quality of life. But even
with good treatment, you may still have some symptoms.

What tests would you have for your symptoms?

If
you have tests, your doctor will decide which ones to do based in part on which
symptoms bother you the most.

At your first visit, your doctor may recommend some of
these tests:

  • Medical history and physical exam
  • A blood test for celiac disease. Many doctors do this test, because the symptoms of IBS and celiac disease can be the same.
  • Tests for lactose intolerance. Taking a breath test or trying a lactose-free diet may show
    that you have trouble digesting lactose.
  • Blood tests. They can show an illness or
    infection.
  • Stool analysis, which may include testing for blood in
    the stool (fecal occult blood test), infection (stool culture), or parasites
    (ova and parasites test)

Your doctor may also recommend other tests not in this list, such flexible sigmoidoscopy or colonoscopy. Whether you have tests before you try home treatment may depend on
your age and health history and which tests your doctor uses the most.

If you have an abnormal test result, it may mean that you
have a problem other than IBS. You also may have both IBS and another
problem.

How can you treat IBS symptoms at home?

Treatment
usually includes making changes to your diet and lifestyle. You may try
to:

  • Increase the fiber in your diet. Try to eat more fresh fruits (such as raspberries, pears, and
    apples) and fresh vegetables (such as carrots and spinach). Also try to eat more whole-grain
    breads and cereals.
  • Avoid or limit gas-producing foods or drinks. These include beans and cabbage, sugar-free chewing gum
    and candy, caffeine, and alcohol.
  • Lower stress.

    • Get regular exercise.
    • Keep a
      journal or diary of events in your life to try to find a link between stress
      and your symptoms.
    • Enjoy hobbies and other activities to help you
      relax.
    • Get counseling if you need help to lower your stress.

What can you do with the information you get from tests?

If your tests are all normal and your symptoms match the
symptoms that are common in people with
IBS, you may feel reassured that you don’t have a
serious problem. You and your doctor can then focus on treating your symptoms
so that they don’t interfere with your life.

If the tests find
that you have another problem, you and your doctor will make a plan to treat
it.

What new problems could develop if you have tests?

Most tests have some risks. But the chance of a serious problem from a
test is low.

Some of the tests, such as
flexible sigmoidoscopy or
colonoscopy, may be uncomfortable. People with IBS may
find these tests more uncomfortable than do people who don’t have
IBS.

What are the risks of not having tests?

There is
usually little risk in not having tests if your symptoms match those of IBS.
The more of these symptoms you have, the more likely it is that you have IBS.

If you have a more serious problem, your symptoms are likely to
get worse.

“Alarm symptoms” also may show that you have a more
serious problem. These symptoms include:

  • A fever.
  • Unexplained weight loss.
  • Blood
    in your stools.
  • Anemia.

If you have any of these alarm symptoms, or if your
symptoms get worse, your doctor will probably recommend tests. If you have a family history of
colon cancer or
inflammatory bowel disease, your doctor will probably recommend tests.

Why might your doctor recommend tests for IBS symptoms?

Your doctor might recommend tests if:

  • Your symptoms are getting worse.
  • Your symptoms have
    come on quickly over the past few weeks to months.
  • Your symptoms
    don’t match those of most people who have IBS.
  • You are older than
    50.
  • You have blood or pus in your stool.
  • You have alarm symptoms, such as unexplained weight loss,
    fever, or diarrhea at night.
  • Your pain often wakes you up at night.

Compare your options

Compare

What is usually involved?

What are the benefits?

What are the risks and side effects?

Have tests for IBS
symptoms

Have tests for IBS
symptoms

  • You follow your doctor’s directions
    for getting ready for the test.
  • If the tests find nothing wrong, it’s
    likely that you have IBS.
  • Knowing that you don’t have a serious problem may give you peace
    of mind.
  • If the test finds something wrong, you can start treating
    it.
  • Tests can be uncomfortable and expensive.
Don’t have tests

Don’t have tests

  • You treat symptoms at home.
    You avoid foods that make your symptoms worse. You also can try to reduce
    stress.
  • If home treatment doesn’t relieve your symptoms, you can decide
    to have tests.
  • Home care might relieve or get
    rid of your symptoms.
  • If home care helps your symptoms, you can be reassured that
    you don’t have a serious problem.
  • You avoid the discomfort and
    costs of testing.
  • Home care might
    not completely relieve your symptoms.
  • You may not know for sure whether you
    have a serious problem.

Personal stories about having tests for irritable bowel syndrome

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I have had
a “nervous stomach” since I was in grade school. When I had to take a big test,
or when I was nervous about something, I would always get stomach cramps and
diarrhea. Recently, I took a new job in a new city. It seems like I have had
diarrhea ever since I started this job. I went to see my doctor about it
because I was getting a little concerned. She asked me a lot of questions and
did some blood tests. She said it seemed very likely that I have irritable
bowel syndrome, and she said that it would be reasonable to do more tests, but
she didn’t feel it was truly needed. I felt a lot better after talking to
her, so we agreed that I would wait another month or so to see what happens.
Then we will talk again and see if I am still having symptoms before we decide
about more tests.

Janna, age 35

I became
nervous about my bowel symptoms when a friend of mine was diagnosed with colon
cancer. I don’t know what symptoms she was having, but it got me very
concerned. I went to my doctor, and he did a thorough exam and asked me a lot
of questions. He said that my symptoms were very similar to those of people who
have irritable bowel syndrome. I asked him how he could be sure without doing
any tests. He said that he couldn’t be absolutely sure, but that he was
confident that I didn’t have anything more serious. I told him that I really
was concerned, and that I would feel better if we did some tests. So I am doing
some home treatment and going in next week for some tests. Even if they don’t
show anything, I know that I will rest easier.

Teresa, age 29

At my last
doctor visit, we talked about my symptoms of cramps, bloating, and
constipation. I’ve had these symptoms for about the last 20 years. My doctor
reminded me that sometimes constipation can be a symptom of colon cancer and
suggested that we talk about whether I should have a colonoscopy. Since I have
had my symptoms for so long, we agreed to try increasing the fiber in my diet
and to talk again in a few more weeks. I’m not too worried, because I have had
these symptoms for so long.

Daniel, age 45

My doctor diagnosed me with irritable
bowel syndrome at my last visit. But I can’t stop wondering if there isn’t
something more seriously wrong with me. I have been doing all the things that
are supposed to help my symptoms, but they are still there, although they are
definitely better. I am going to ask my doctor if it is reasonable for me to
have more tests to find out whether there might be something else going on.

Marcie, age
37

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have tests for IBS symptoms

Reasons not to have tests

Even if home care helps my symptoms, I’ll worry that I have something serious.

If home care helps my symptoms, I won’t worry that I have something serious.

More important
Equally important
More important

I don’t want to wait and see if home care gets rid of my symptoms.

I want to give home care a chance to relieve my symptoms.

More important
Equally important
More important

I don’t mind if the tests are a little uncomfortable.

I don’t want to have tests that could be uncomfortable unless I have to.

More important
Equally important
More important

I don’t mind having tests that might be costly.

I can’t afford costly tests.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you’ve thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having tests

NOT having tests

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1, Can tests show that you have IBS?
2, Should you have tests if your IBS symptoms get better with home care and changes to your diet?
3, Do normal tests results mean that you don’t have IBS?

Decide what’s next

1,Do you understand the options available to you?
2,Are you clear about which benefits and side effects matter most to you?
3,Do you have enough support and advice from others to make a choice?

Certainty

1.
How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure


Your Summary

Here’s a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision 

Next steps

Which way you’re leaning

How sure you are

Your comments

Your knowledge of the facts 

Key concepts that you understood

Key concepts that may need review

Getting ready to act 

Patient choices

Credits

Credits
Author Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD – Internal Medicine
Primary Medical Reviewer Adam Husney, MD – Family Medicine
Specialist Medical Reviewer Arvydas D. Vanagunas, MD – Gastroenterology
You may want to have a say in this decision, or you may simply want to follow your doctor’s recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Irritable Bowel Syndrome: Should I Have Tests for IBS Symptoms?

Here’s a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the Facts

Your options

  • Accept your doctor’s diagnosis of irritable bowel syndrome. Try
    home treatment. If it helps your symptoms, you may feel reassured that you
    have IBS rather than another problem.
  • Have tests to make sure that you don’t have a more serious
    problem.

Key points to remember

  • There are no tests that can diagnose
    irritable bowel syndrome (IBS). Instead, experts use a
    set of
    criteria that help your doctor decide whether you have
    IBS. Your doctor probably will ask you a lot of questions about your symptoms
    to see how well your symptoms match these criteria.
  • If your symptoms get better with home care and changes to your
    diet, you likely have IBS and don’t need tests for other digestive problems. If
    your symptoms don’t get better, your doctor probably will want you to have some
    tests.
  • If you have IBS, your test results for other digestive problems
    will be normal. An abnormal test result may mean that you have a problem other
    than IBS.
  • If your tests are all normal and your symptoms match the
    symptoms common in people with IBS, you probably don’t have a serious problem.
    You and your doctor can then focus on relieving your symptoms so that they
    don’t interfere with your life.
  • When deciding whether to have tests, weigh the chance that you
    may have a more serious problem against the risks, discomfort, and costs of
    tests.
  • If any of the following apply to you, your doctor probably
    will want to do tests to make sure that you don’t have a more serious problem:

    • You are older than 50.
    • You have blood or pus in your stool.
    • Your symptoms have come on quickly over the past few weeks
      to months.
    • You have had unexplained weight loss, fever, or diarrhea at
      night.
    • Your pain wakes you up at night.
FAQs

What is irritable bowel syndrome (IBS)?

Irritable bowel syndrome (IBS) is a common digestive
problem. Many people have symptoms of IBS (such as diarrhea, constipation,
bloating, and belly pain) and never see a doctor about them. Other people may
choose to see a doctor because they are concerned about their symptoms or
because the symptoms are affecting their life.

It is not clear what causes irritable bowel syndrome, and the cause may be different for different people. Some ideas about what causes IBS include problems with the way signals are sent between the brain and the digestive tract , problems digesting certain foods, and stress or anxiety. People with IBS may have unusually sensitive intestines or problems with the way the muscles of the intestines move.

There are no tests that can diagnose IBS. Instead,
experts use a set of
criteria that help your doctor decide whether you may
have IBS. Your doctor will likely ask you a lot of questions about your
symptoms to see how well your symptoms match these criteria.

Treating the symptoms of IBS can improve your quality of life. But even
with good treatment, you may still have some symptoms.

What tests would you have for your symptoms?

If
you have tests, your doctor will decide which ones to do based in part on which
symptoms bother you the most.

At your first visit, your doctor may recommend some of
these tests:

  • Medical history and physical exam
  • A blood test for celiac disease. Many doctors do this test, because the symptoms of IBS and celiac disease can be the same.
  • Tests for lactose intolerance. Taking a breath test or trying a lactose-free diet may show
    that you have trouble digesting lactose.
  • Blood tests. They can show an illness or
    infection.
  • Stool analysis, which may include testing for blood in
    the stool (fecal occult blood test), infection (stool culture), or parasites
    (ova and parasites test)

Your doctor may also recommend other tests not in this list, such flexible sigmoidoscopy or colonoscopy. Whether you have tests before you try home treatment may depend on
your age and health history and which tests your doctor uses the most.

If you have an abnormal test result, it may mean that you
have a problem other than IBS. You also may have both IBS and another
problem.

How can you treat IBS symptoms at home?

Treatment
usually includes making changes to your diet and lifestyle. You may try
to:

  • Increase the fiber in your diet. Try to eat more fresh fruits (such as raspberries, pears, and
    apples) and fresh vegetables (such as carrots and spinach). Also try to eat more whole-grain
    breads and cereals.
  • Avoid or limit gas-producing foods or drinks. These include beans and cabbage, sugar-free chewing gum
    and candy, caffeine, and alcohol.
  • Lower stress.

    • Get regular exercise.
    • Keep a
      journal or diary of events in your life to try to find a link between stress
      and your symptoms.
    • Enjoy hobbies and other activities to help you
      relax.
    • Get counseling if you need help to lower your stress.

What can you do with the information you get from tests?

If your tests are all normal and your symptoms match the
symptoms that are common in people with
IBS, you may feel reassured that you don’t have a
serious problem. You and your doctor can then focus on treating your symptoms
so that they don’t interfere with your life.

If the tests find
that you have another problem, you and your doctor will make a plan to treat
it.

What new problems could develop if you have tests?

Most tests have some risks. But the chance of a serious problem from a
test is low.

Some of the tests, such as
flexible sigmoidoscopy or
colonoscopy, may be uncomfortable. People with IBS may
find these tests more uncomfortable than do people who don’t have
IBS.

What are the risks of not having tests?

There is
usually little risk in not having tests if your symptoms match those of IBS.
The more of these symptoms you have, the more likely it is that you have IBS.

If you have a more serious problem, your symptoms are likely to
get worse.

“Alarm symptoms” also may show that you have a more
serious problem. These symptoms include:

  • A fever.
  • Unexplained weight loss.
  • Blood
    in your stools.
  • Anemia.

If you have any of these alarm symptoms, or if your
symptoms get worse, your doctor will probably recommend tests. If you have a family history of
colon cancer or
inflammatory bowel disease, your doctor will probably recommend tests.

Why might your doctor recommend tests for IBS symptoms?

Your doctor might recommend tests if:

  • Your symptoms are getting worse.
  • Your symptoms have
    come on quickly over the past few weeks to months.
  • Your symptoms
    don’t match those of most people who have IBS.
  • You are older than
    50.
  • You have blood or pus in your stool.
  • You have alarm symptoms, such as unexplained weight loss,
    fever, or diarrhea at night.
  • Your pain often wakes you up at night.

2. Compare your options

  Have tests for IBS
symptoms
Don’t have tests
What is usually involved?
  • You follow your doctor’s directions
    for getting ready for the test.
  • You treat symptoms at home.
    You avoid foods that make your symptoms worse. You also can try to reduce
    stress.
  • If home treatment doesn’t relieve your symptoms, you can decide
    to have tests.
What are the benefits?
  • If the tests find nothing wrong, it’s
    likely that you have IBS.
  • Knowing that you don’t have a serious problem may give you peace
    of mind.
  • If the test finds something wrong, you can start treating
    it.
  • Home care might relieve or get
    rid of your symptoms.
  • If home care helps your symptoms, you can be reassured that
    you don’t have a serious problem.
  • You avoid the discomfort and
    costs of testing.
What are the risks and side effects?
  • Tests can be uncomfortable and expensive.
  • Home care might
    not completely relieve your symptoms.
  • You may not know for sure whether you
    have a serious problem.

Personal stories

Personal stories about having tests for irritable bowel syndrome

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

“I have had a “nervous stomach” since I was in grade school. When I had to take a big test, or when I was nervous about something, I would always get stomach cramps and diarrhea. Recently, I took a new job in a new city. It seems like I have had diarrhea ever since I started this job. I went to see my doctor about it because I was getting a little concerned. She asked me a lot of questions and did some blood tests. She said it seemed very likely that I have irritable bowel syndrome, and she said that it would be reasonable to do more tests, but she didn’t feel it was truly needed. I felt a lot better after talking to her, so we agreed that I would wait another month or so to see what happens. Then we will talk again and see if I am still having symptoms before we decide about more tests.”

— Janna, age 35

“I became nervous about my bowel symptoms when a friend of mine was diagnosed with colon cancer. I don’t know what symptoms she was having, but it got me very concerned. I went to my doctor, and he did a thorough exam and asked me a lot of questions. He said that my symptoms were very similar to those of people who have irritable bowel syndrome. I asked him how he could be sure without doing any tests. He said that he couldn’t be absolutely sure, but that he was confident that I didn’t have anything more serious. I told him that I really was concerned, and that I would feel better if we did some tests. So I am doing some home treatment and going in next week for some tests. Even if they don’t show anything, I know that I will rest easier.”

— Teresa, age 29

“At my last doctor visit, we talked about my symptoms of cramps, bloating, and constipation. I’ve had these symptoms for about the last 20 years. My doctor reminded me that sometimes constipation can be a symptom of colon cancer and suggested that we talk about whether I should have a colonoscopy. Since I have had my symptoms for so long, we agreed to try increasing the fiber in my diet and to talk again in a few more weeks. I’m not too worried, because I have had these symptoms for so long.”

— Daniel, age 45

“My doctor diagnosed me with irritable bowel syndrome at my last visit. But I can’t stop wondering if there isn’t something more seriously wrong with me. I have been doing all the things that are supposed to help my symptoms, but they are still there, although they are definitely better. I am going to ask my doctor if it is reasonable for me to have more tests to find out whether there might be something else going on.”

— Marcie, age
37

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have tests for IBS symptoms

Reasons not to have tests

Even if home care helps my symptoms, I’ll worry that I have something serious.

If home care helps my symptoms, I won’t worry that I have something serious.

             
More important
Equally important
More important

I don’t want to wait and see if home care gets rid of my symptoms.

I want to give home care a chance to relieve my symptoms.

             
More important
Equally important
More important

I don’t mind if the tests are a little uncomfortable.

I don’t want to have tests that could be uncomfortable unless I have to.

             
More important
Equally important
More important

I don’t mind having tests that might be costly.

I can’t afford costly tests.

             
More important
Equally important
More important

My other important reasons:

My other important reasons:

   
             
More important
Equally important
More important

4. Where are you leaning now?

Now that you’ve thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having tests

NOT having tests

             
Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
Can tests show that you have IBS?

  • Yes

  • No
  • I’m not sure

You’re right. There are no tests to diagnose IBS. Doctors diagnose IBS using a list of symptoms common to people who have IBS.

2.
Should you have tests if your IBS symptoms get better with home care and changes to your diet?

  • Yes

  • No
  • I’m not sure

You’re right. If your symptoms get better with home care and changes to your diet, you likely have IBS and don’t need testing.

3.
Do normal tests results mean that you don’t have IBS?

  • Yes

  • No
  • I’m not sure

You’re right. Normal test results mean that you probably do have IBS. Tests look for other health problems that could cause your symptoms. So abnormal results may mean that you have another problem.

Decide what’s next

1.
Do you understand the options available to you?

2.
Are you clear about which benefits and side effects matter most to you?

3.
Do you have enough support and advice from others to make a choice?

Certainty

1.
How sure do you feel right now about your decision?

         
Not sure at all
Somewhat sure
Very sure

2.
Check what you need to do before you make this decision.

  • I’m ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

 

Credits
By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD – Internal Medicine
Primary Medical Reviewer Adam Husney, MD – Family Medicine
Specialist Medical Reviewer Arvydas D. Vanagunas, MD – Gastroenterology

Note: The “printer friendly” document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.